Injecting Rooms: Have we progressed since the 1970’s

As the debate heats up in Brighton over the introduction of injecting rooms it is worth reflecting that this contentious discussion has taken place over the last 40 years.  At its heart is the concern between condoning illicit drug use pitched against reducing the very real risk of death, overdose, serious injury and infection that can come with poor injecting practice and hygiene.  It is a debate between a morale high ground and a pragmatic non-judgemental response to the risks injecting drug users face.

As we watch, hear and feel the passion from those involved in the debate about the possible introduction of injection rooms there is a feeling of déjà vu at Blenheim and our long history documents similar debates in the 1960’s and 1970’s.

In the late 1960’s until the mid 1970’s Blenheim (CDP operating in South London) provided clients with places they could inject safely and in private.  This was 15-20 years prior to the development of needle exchanges.

As now this practice was subject to heated and often angry debate.  The practice was even more controversial now as attitudes to drugs and those injecting illicit drugs were far less tolerant than they are today.  For most people the idea that people using heroin and other drugs should be given special facilities in which to take their drugs was seen as actively condoning and encouraging drug use and conferring a social acceptability.  It was not just the public at large this view was also widely held by many working in the substance misuse sector.

The running of injecting rooms was not without its practical difficulties as services ran on a fraction of today’s resources.  In the 1970 CDP annual report records that:

“Limiting the hours that the injecting room is open may well increase the instance of addicts injecting themselves in public, and stir up once more public opposition.”

This suggests a real concern to move injecting off the streets in part to reduce local opposition to CDP and to remove the practice from the public eye. This was indeed the case.  “You are actively encouraging and condoning an illegal and destructive activity” was a typical comment recorded in the 1970 CDP annual return documenting public feedback.  The 1970 document goes on to starkly record that:

“The mounting of a public campaign with protest meetings and accompanying press coverage poses a threat to the continued existence of our project (CDP).”

Doubts about the practice were not just coming from the community in South London within CDP there were also doubts about the validity of injection rooms. Concerns were documented that injection rooms could be;

“Seen to run counter our therapeutic aims, perhaps reinforcing a drug using culture and protecting the addict from the realities of life, however unpleasant.”

As an organisation CDP in the 1970’s was a community organisation torn between the needs of injecting drug users and its responsibility to the local community which it could not afford to alienate.

This tension was articulated in the following quote from an annual report:

“These are problems facing anybody who attempts the difficult task of reconciling the communities interests with those of a group that society fears and finds so hard to accept.  In declaring our interest with both we perhaps assume, and are ascribed, the role of King Soloman, yet lack the necessary wisdom.”

Debbie Lindsey, Chief Operating Officer Blenheim, is disappointed about progress:

“With the considerable changes across the drugs misuse sector over the last 20years and the mainstreaming of services including needle exchange, the tangible developments such as evidenced best practice, policy and guidance, recording and data collection, recovery focus, and workforce competence to name but a few, it is disappointing that the stigma of drug dependency is still increasingly present, and as a society we have not developed a collective wisdom that removes the role of King Soloman.”

The world has moved on, what was a reasonable debate and tension in the 1970’s pre HIV and the national availability of state funded needle exchange provision seems completely illogical to me today.  If we accept the need to provide needles, syringes and safer injecting equipment to drug users it seems to me outrageous not to be able to provide a safe place for people to inject where there is a need.  The debate remains whether we should provide needle exchange equipment or not, injecting rooms are simply a logical extension of existing service provision.

It seems that safe injecting rooms remain a particularly contentious issue for the UK but many Canadian  and European cities report, in line with Blenheim CDP’s experience in the 1960’s and 1970’s that injecting rooms have had a positive impact by minimising drug use in public and providing a safe place for users to go.  It is sad that in the UK even a relatively liberal place such as Brighton, struggles to come to terms with the issue.

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